Greg Romaniuk sat on a hospital bed in a room with cardboard walls and motioned toward the area meant to represent the bathroom.

A little earlier in the day, the bathroom door was in a different spot. But the location wasn't quite right.

Moving it over a bit would make it easier for patients and save time for staffers -- maybe 15 or so seconds. While that might not sound like much, "15 seconds, times all those patients ... 15 seconds makes a difference," said Romaniuk, who is helping lead an expansion project at Kadlec Regional Medical Center in Richland.

The bathroom door change was exactly the kind of insight Romaniuk and other Kadlec officials were looking for during several days of "rapid prototype" planning for the expansion of the River Pavilion.

Four more floors are to be added to the pavilion, and this week nurses, physicians, architects and others have been using life-size prototypes set up in a Kennewick warehouse to get a better sense of what works and what doesn't.

"We've actually put up walls that are cardboard so that we can look at the big portion of our core and at patient rooms, so we can see if taking stretchers in, running a code, all the basic things we do every day -- if it's going to work in the spaces," said Kathy Christensen, manager of an acute care unit that'll move into the expanded pavilion.

Kadlec is a couple of months into a roughly 10-month design period for the expansion. The rapid prototype work this week builds on input provided by staffers earlier in the process.

"This has been a wonderful experience," said Dr. Syed Hashmi, a hospitalist.

He noted that Kadlec has sought insight from many kinds of staffers, from nurses and doctors to physical and respiratory therapists.

"We are building based on our vision," he said.

The River Pavilion opened in 2008. Its six floors hold operating rooms, a short-stay unit and pediatrics, among other services.

The addition is planned to include two intensive care and two acute care floors. Construction, which is estimated to cost about $40 million, is to start next spring.

The past few years have been busy for Kadlec Health System in terms of capital projects.

In April, Kadlec opened a new healthplex on Lee Boulevard that's home to numerous outpatient services.

Other recent projects have included the new standalone emergency department in the Southridge area of Kennewick and a three-story, 60,000-square-foot medical office building on Goethals Drive in Richland.

A new neonatal intensive care unit at the hospital is on track to open for patients in October.

Romaniuk said Thursday that the rapid prototype process being used for the pavilion expansion has been effective. The idea is to find ways to improve work flow and efficiency with patients in mind.

When waste is eliminated, "they have more time to spend at the patient's bedside, and that's more value added to the patient," he said.

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